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Hemoglobin A1C and What Tattoo Artists Need to Know About Diabetic Clients

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So, it comes down to this: if a diabetic wants a tattoo, they’ve got to be fastidious about their disease management and have good control over their blood glucose levels. Otherwise, a tattoo could be downright dangerous. So, what determines whether or not a diabetic has control? The hemoglobin A1C test is the most important tool to knowing how well one’s diabetes is being managed.

Hemoglobin A1C
A1C is glucose “infused” hemoglobin, which is a protein inside your red blood cells that’s responsible for carrying oxygen from your lungs to the rest of your body. If a person’s blood sugar is high, the excess sugar attaches itself to the hemoglobin. The fusion created is permanent for the life span of the red blood cell, which is typically around 120 days. Scientists have discovered that testing a person’s A1C level, or how much glucose has been bound to the hemoglobin, gives them a pretty accurate report of a patient’s average glucose levels over the past 90-120 days. That’s why it’s so important for every diabetic to have an A1C test every 3 months.

The reason this is important if a diabetic wants a tattoo is because the A1C test result is the best indicator of how well that person is managing their diabetes. A non-diabetic human’s A1C is typically between four and six percent. A diabetic with excellent control of their blood glucose may actually manage to get inside that range, but it’s extremely difficult. The goal of most diabetes patients is to remain under 7%. Eight and nine percent are mid-to-high ranges that indicate a significant number of high blood sugar numbers. Ten percent and over is considered badly controlled diabetes or could also be a newly diagnosed patient; it takes a while to get the numbers down.

If a diabetic wants a tattoo and their last two-three A1C tests were under 8%, and they don’t already have neurological problems, heart disease, or kidney damage, getting a tattoo should be safe. They just need to keep it clean and continue to keep their blood glucose levels in range. Their body shouldn’t have any trouble healing the tattoo as long as they take good care of it.

However, if a diabetic wants a tattoo and their last few A1Cs were 9% or over, or if they’re already experiencing neuropathy and circulation issues or kidney problems, getting a tattoo could literally put their lives in danger. If the tattoo can’t heal quickly, it becomes a playground for bacteria which leads to infection, which can in turn lead to gangrene and even heart disease. This is not something that should be taken lightly – if you’re a diabetic and you don’t have your sugar under control, do not get a tattoo. It’s just not worth losing your leg or your life over!

What the Artist Needs to Know
If you’re a tattoo artist and you know a client is diabetic, I suppose the responsibility is theirs to decide if this is a wise idea or not. You can’t grill them about their A1C results, but you might want to inform them that mismanaged diabetes and tattoos don’t go well together. But in most cases, you probably won’t even know your client is diabetic. They don’t look any different unless you happen to see them checking their sugar or dialing in an insulin dosage on their pump. Many with uncontrolled diabetes may sit in your chair and you’ll never know it unless they come back two weeks later, trying to blame you for the infection they got. I think this is just one of many reasons that every client sheet should have a medical disclaimer.

But if a client tells you that they’re diabetic and asks if it’s still okay for them to get a tattoo, that’s where this information will come in handy. You can share with them what you’ve learned here, and it never hurts to suggest that they get an official “okay” from their diabetes doctor. And I would add to their client sheet that you discussed the risks with them and they accept responsibility for their decision. It’s important that you protect yourself from liability if a client gets sick from a tattoo when they have a pre-existing condition.

Before beginning the actual tattoo, especially if it's going to be a large one, the client should check their blood glucose level and then continue to check once every hour or so. The strain that getting tattooed puts on the body can be even worse for a diabetic, and the last thing either of you wants is for them to have a seizure in the middle of a tattoo. Monitoring blood sugar levels is the best way to prevent that from happening.

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